Youm Seung-Mok, Kim Ji Young, Lee Jeong Rim
Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Korean J Anesthesiol. 2015 Apr;68(2):188-92. doi: 10.4097/kjae.2015.68.2.188. Epub 2015 Mar 30.
A 21-year-old female with a history of bulimia nervosa came to the emergency room due to severe abdominal pain after excessive eating five hours previously. On arrival at the emergency room, extreme abdominal distension was detected and the patient's legs changed color. Computed tomography suggested severe gastric dilatation, so abdominal compartment syndrome was suspected and an emergent laparotomy was supposed to be conducted. Though anesthesia was induced without event, abrupt hemodynamic collapse developed just after the operation started. In spite of active resuscitation for 29 min, the patient did not recover and expired. As the incidence of eating disorders is increasing, anesthesiologists should keep in mind the possibility of abdominal compartment syndrome in patients with a recent history of binge eating, and prepare optimal anesthetic and resuscitation remedies against sudden deteriorations of a patient's condition.
一名21岁有神经性贪食症病史的女性，因5小时前暴饮暴食后出现严重腹痛前来急诊室。到达急诊室时，发现腹部极度膨胀，患者腿部变色。计算机断层扫描提示严重胃扩张，因此怀疑有腹腔间隔室综合征，拟行急诊剖腹手术。尽管麻醉诱导过程顺利，但手术刚开始后就突然发生血流动力学崩溃。尽管积极复苏29分钟，患者仍未恢复并死亡。由于饮食失调的发病率在增加，麻醉医生应牢记近期有暴饮暴食史的患者发生腹腔间隔室综合征的可能性，并针对患者病情的突然恶化准备最佳的麻醉和复苏措施。
